低强度激光促进正畸牙移动的Meta分析和系统评价

目的：评价低强度激光治疗（low?level laser therapy ，LLLT）促进正畸牙移动的有效性及相关风险。方法依据Cochrane Handbook的规范化要求，检索1980年-2014年Medline、PubMed等数据库，运用Review Manager 5.1软件进行Meta分析。结果共纳入6个国家6篇随机对照试验，3篇不完全随机对照试验，211名患者。偏倚风险评价显示5个研究为中度偏倚风险，4个研究为高度偏倚风险。Meta分析结果显示：与对照组相比，LLLT组治疗后7 d，正畸牙移动速度显著增加（MD=0.19，95%CI 0.02?0.37，P=0.03），该优势持续到治疗后2个月（MD=1.08，95%CI 0.16?2.01，P=0.02）；相对于高能量密度（20或25 J/cm2）的LLLT治疗，低能量密度（2.5，5或8 J/cm2）的LLLT治疗更为有效。结论低能量密度（2.5、5或8 J/cm2）的LLLT能有效促进正畸牙移动，但还需要更多临床随机对照试验支撑。

Low-level laser therapy for accelerating orthodontic tooth movement:a Meta-analysis and systematic review

Objective To evaluate the efficacy and related risk of low level laser therapy (LLLT) for accelerating tooth movement during orthodontic treatment. Methods An extensive electronic search was conducted by two review?ers. Randomized controlled trials (RCTs) and quasi?RCTs concerning the efficacy of LLLT for accelerating tooth move?ment during orthodontic treatment were searched in CENTRAL, PubMed, Medline, Embase, CBM, CNKI. Results Six RCTs and three quasi?RCTs, involving 211 patients from six countries, were selected from 173 relevant studies. All nine articles were feasible for the systematic review and meta?analysis, five of which were assessed as moderate risk of bias, while the rest were assessed as high risk of bias. The mean difference and the 95%confidence interval (95%CI) of accu?mulative moved distance of teeth were observed among all the researches. The results showed that the LLLT could acceler?ate orthodontic tooth movement in 7 days (MD=0.19, 95%CI 0.02?0.37, P=0.03) and 2 months (MD=1.08, 95%CI 0.16?2.01, P=0.02). Moreover, a relatively lower energy density (2.5, 5 and 8 J/cm2) was seemingly more effective than 20 and 25 J/cm2 and even higher ones. Conclusion This systematic review and meta?analysis demonstrated that LLLT might speed up the tooth movement in orthodontic treatment. A relatively lower energy density (2.5, 5, and 8 J/cm2) was seemingly more effective than higher ones. More qualified RCTs in human subjects are required.